The hidden financial costs of suffering from cancer are revealed today as it emerged that patients face a bill of more than #300 just to get to the hospital for treatment.

A cancer charity said patients are having to pay a 'stealth tax' on their illness as they shoulder the considerable burden of travelling and hospital parking costs.

Macmillan Cancer Support is now calling on the Welsh Assembly Government to scrap hospital parking charges for all cancer patients and to offer them financial help with their travel costs.

The call comes as research has revealed that a cancer patient makes an average of 53 journeys to hospital during the course of their treatment.

In some cases patients, especially those living in Powys and other rural parts of Wales, face trips of 100 miles or more to their nearest treatment centre.

The research by Macmillan Cancer Support also raises the thorny issue of whether patients should have to pay to park at hospital, and the high price of parking levied by NHS trusts or their private car parking contractors.

Cath Lindley, Macmillan Cancer Support's director for Wales, said, 'Although cancer patients in Wales have the lowest costs, they still have to pay a lot of money to get to hospital.

'Missing an appointment is not an option for cancer patients - they have no option but to pay travel and parking, which amounts to a stealth tax on illness.'

Almost 17,000 people are diagnosed with cancer in Wales every year - the numbers are rising steadily - a majority of whom will need to keep regular hospital appointments for chemotherapy or radiotherapy for many months.

Macmillan's research, published today in its Cancer Costs report, found that cancer patients have to make an average of 53 trips to hospital in the course of their treatment, costing anywhere from #10 to #10,000.

A typical course of radiotherapy may involve a daily round trip to hospital for five days a week for up to six weeks - up to 30 trips to hospital.

As radiotherapy is usually delivered in specialist treatment centres servicing large catchment areas - especially in rural areas - patients may have to make lengthy round trips every weekday throughout the course of their treatment.

The report said that Gareth Price, a patient living in Llandrindod, was forced to stay in hospital when his 90-mile daily round trip to Cheltenham became too stressful.

And Jacqueline Lloyd, from Builth Wells, who is on a drug trial, must make the 64-mile trip to a hospital in Hereford every three months for the next five years.

Some financial help towards travelling costs is available for some people who receive Family Credit, Income Support, have a low income or claim certain other benefits.

But there is little escape from parking charges.

It costs between #1 and #2 to park on most Welsh hospital grounds for between one and four hours - parking at Prince Charles Hospital, in Merthyr Tydfil, is still free - and many trusts have hired private contractors to run their car parking.

NHS trusts have been reluctant to reveal how much money they get from car parking, although most have said that any income is re-invested in direct patient care.

Helen Mary Jones, Plaid Cymru's Shadow Health Minister said, 'Regular visits to hospitals are a necessity for many people with cancer which can mean considerable cost implications for patients, especially if hospitals have implemented a charge for car parking.

'We should be looking for a way to ease patient access to NHS services, not putting up barriers.'

A spokeswoman for the Welsh Assembly Government said that wherever possible treatments, especially follow-up treatments, should be undertaken locally to reduce travel costs.

He said that the Welsh Assembly Government intends to develop an all-Wales medical needs criteria.

'This would ensure that free non-emergency patient transport is provided across Wales, in particular to patients with defined need.'

He added, 'The Minister is aware of concerns over the cost of parking at NHS hospitals but responsibility for parking is an issue for individual NHS Trusts.'

Genetic testing for breast cancer problems leaves women opting for surgery before results are known after 'appalling' waits

Women are suffering 'agonising delays' of two years or more for test results to see if they carry a faulty breast cancer gene.

In some parts of the UK, women with a strong family history of breast cancer are choosing to have their breasts removed rather than wait long periods for the results, a report from the charity Breakthrough Breast Cancer said.

Some women go private to get the results more quickly, but many are forced to wait months between having the test and finding out if they are at risk. In some cases, women who had tests in 2002 are still waiting, while there were wide variations between laboratories.

Although Wales does carry out the genetic tests for cancer, there are currently no targets for the time in which results have to be issued.

In England, the government's 2003 genetics White Paper promised that, by 2006 anyone taking a genetic test should receive their results within eight weeks for diagnostic testing and two weeks for predictive testing.

Breakthrough Breast Cancer yesterday admitted that the tests can take a few weeks but said the process is causing unnecessary anguish.

About 5% of the 41,000 cases of breast cancer diagnosed in the UK each year are due to inherited faults in genes associated with a strong family history of the disease.

A further 10% to 15% of all breast cancer cases occur in women who have a moderate family history of the disease.

The charity said it compiled its report after speaking to more than 50 women with a personal experience of waiting for a genetic test - including some from Wales - and 27 genetic counsellors.

It found that 55% of counsellors had patients who had opted to have their breasts removed while waiting for their own result or that of an affected relative.

Over half (59%) had patients who decided to go private because they had waited so long.

Over two-thirds (70%) of patients waiting for a result said the wait made them worry about their own health or the health of their relatives.

The majority of women surveyed (70%) and over half of genetic counsellors said the current situation was unacceptable.

Jeremy Hughes, chief executive of Breakthrough Breast Cancer, said, 'It's unacceptable that women are forced to put their lives on hold as they wait so long to get these vital test results. The decision to take such a test is extremely personal, complex and difficult enough.

'That some then feel compelled to make crucial healthcare decisions out of fear of developing breast cancer while waiting for their test results is appalling.'

Professor Alan Ashworth, director of the Breakthrough Toby Robins Breast Cancer Research Centre, added, 'Genetic testing is one of the best examples of how genetic knowledge can be harnessed to benefit people's health and healthcare. Over the next few decades, as science advances, the diagnosis and management of certain conditions will increasingly rely on this kind of testing. It will have a large impact on the future of public health through the prediction and ultimately the prevention of disease.

'If patients are to benefit from future treatments targeted at specific genetic make-up we need robust systems in place that guarantee people get their genetic test results back in good time.'

A Welsh Assembly spokesman said it was working to the 2003 White Paper targets in genetic testing. 'These are that urgent tests should be turned around within three days. Tests on a known mutation should be turned around within two weeks, and tests involving screening of a large gene for an unknown mutation should be turned around within eight weeks.'

He added that in Wales there is no analytical backlog for testing, and experts here are helping colleagues in England to clear their backlog.